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The constitution of the human body
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Karin Preisendanz
is Professor for Indology at the Institute of South Asian, Tibetan and Buddhist Studies, University of Vienna.
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Amaladass: Today the discussion on human genetics has taken center stage. On the one hand there is an urge to show human achievement in the scientific field. On the other hand there is a strong reaction against this tendency by those who claim that this amounts to playing the role of God, interfering with the divine plan of creation, and destroying the dignity of human life by reducing it to the level of a robot. In this context, what would be the response to these problems from the point of view of āyurveda tradition in India, since you are involved with the textual study of this tradition?
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Preisendanz: First of all, it has to be stressed that the classical āyurveda tradition in India does not refer to a notion of God in its theoretical and practical medical teachings. The Carakasaṃhitā, one of the two fundamental compendia of classical āyurveda and probably the older among the two, contains a wealth of information on the metaphysical, ethical, and soteriological foundations of āyurveda as they were maintained in the first two or three centuries CE. Even though the compendium reflects at least two stages of ideological development within early classical āyurveda, in neither of them can we find the notion of a creator-god who is also responsible for the creation of the human body.
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The older ideology can be characterized as a philosophy of nature focusing on ontology: the external and internal world with its multitude of entities and occurrences is analyzed and brought into a categorical framework to explain causal processes, in the widest sense and specifically with regard to the body and its transformations – that is, the initial formation of the body and its changing states of health and sickness. As we can also discern from other sources on early classical philosophy of nature in India, there is no place for God in this pluralistic and »mechanical« world-view; however, the residue of deeds performed in earlier lives is a crucial factor in the formation of the human body.
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The second ideology, which seems to have subsequently affected classical āyurveda, presumes a dualism of mind and matter, with pure consciousness as an unchanging eternal phenomenon on the one hand and matter as the constantly changing world of external and internal – macro- and microcosmic – phenomena and events on the other hand. In this ideology there is equally no scope for the activity of a creator-god because matter – affected by the mere presence of consciousness – acts by itself for the latter's sake; this includes the formation – again in consonance with the effects of previous deeds – and transformations of the human body.
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There is, however, mention of a very important divine role in classical āyurveda, namely, in the various accounts of its »origin« and transmission to human beings which reflect the cultural self-perception of the early classical physicians of India and their attempts to integrate their non-orthodox science into the dominant world view of the first centuries CE. Even though āyurveda (literally »the knowledge of the [human] life-span/life-force«) is eternal according to the Carakasaṃhitā, it was first pronounced by God Brahmā, the creator, to Prajāpati, who is conceived as the creator of rituals and other religious institutions and father of humankind. Prajāpati transmitted this knowledge to the twin-gods called the Aśvins who figure as divine healers in the oldest Indian mythology. From the Aśvins āyurveda passed on to God Indra, the most powerful »king of the gods« of Vedic and Epic mythology.
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»In the beginning Prajāpati grasped the knowledge about the human life-span/life-force in its entirety, as it had been proclaimed by Brahmā; the two Aßvins (grasped it) from Prajāpati. Venerable Indra wholly obtained (this knowledge) from the Aśvins …« (Carakasaṃhitā, Sūtrasthāna 1, verse 4-5ab)
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When diseases arose in this world, Indra imparted the »knowledge about life« to compassionate sages who had approached him for help because the diseases kept human beings from observing their various religious duties and attaining the four aims of man, i.e., religious merit, material wealth, worldly pleasures, and salvation.
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»And the sages, desirous to effect a long life-span (for themselves and other human beings), received this knowledge which is beneficial for human creatures (and) increases (their) life-span/life-force from (sage) Bharadvāja.« (Carakasaṃhitā, Sūtrasthāna 1, verse 27)
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Āyurveda, as a means to pacify disease, was subsequently visualized and interiorized by the sages and its methods successfully applied to themselves. Only then, out of compassion and love for the human beings, one of these seers proceeded to teach āyurveda to a group of students who are considered as the human »founders« of āyurveda.
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»Then (sage) Punarvasu, full of love, out of compassion for all living beings bestowed the meritorious āyurveda on six disciples.« (Carakasaṃhitā, Sūtrasthāna 1, verse 30)
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Inasmuch as the constitution of the human body as conceived according to the philosophy of nature underlying classical āyurveda is part of the eternal medical teachings proclaimed by divine figures, one could therefore argue that in āyurveda the human body, although not created according to divine design, is an integral part of an ontological scheme promulgated and sanctioned by God(s). Further, within both ontological frameworks of classical āyurveda I have mentioned for the Carakasaṃhitā, which are also valid for later āyurveda, it would be inconceivable that physicians would strive after changing the natural composition of the human body which is a product of the natural elements and a microcosmic transformation of primordial matter respectively; from both the ideological viewpoints of Indian philosophy of nature and of mind-matter dualism, the body – being integrated in the orderly scheme of nature/matter from the point of view of its composition – is beyond the realm of human manipulation.
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Mind, soul and body as a foundation of the world
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Amaladass: What is the role of the body in āyurveda tradition? Is it merely an object of scrutiny to be analyzed and treated as something sick that needs to be healed? Or is there a reverential attitude to the body, the material element, or is it even respected here, because – as usual in the dominant spiritual tradition – it is housing the soul which is superior, etc., a notion coming from ātmologists?
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Preisendanz: The story about the »origin« of āyurveda already gives some indications about the role of the body: it is conceived in its healthy, natural state as one of the presuppositions for successfully conducting activities such as the performance of religious penance, fasting, studying the traditional scriptures, leading the life of a person who piously strives for heaven or salvation, and observing religious vows. Beyond the realm of religious duty and efforts to achieve salvation, the healthy body is also implicitly recognized as being essential for obtaining a livelihood and worldly pleasures.
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»Health is the ultimate root of religious merit, material wealth, worldly pleasures and salvation; diseases are robbers of it, (and thus) of welfare and of life.« (Carakasaṃhitā, Sūtrasthāna 1, verse 15cd-16ab)
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The body is therefore more than a mere object of scholarly analysis and healing. Together with the mind and the soul it functions as a foundation of this world.
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»Mind, soul and body – these three are like a tripod: the world ›stands‹ because of (their) conjunction; everything rests on them.« (Carakasaṃhitā, Sūtrasthāna 1, verse 46)
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Furthermore, the body is the seat of the conscious element or soul already in the state of an embryo and the place of its experience and activity; however, a special reverence for it on this account is not expressed in the classical treatises. On the other hand, (wo)man is conceived as being made up of six elements: the five material elements earth, water, etc., which constitute the body and the senses, and consciousness, that is, the soul accompanied by the mind. In this analysis, the body appears as an integral and important part of (wo)man even though the conscious element is certainly superior to it owing to its eternity, essential immutability and agency; as a substantial component of (wo)man or the person the body deserves respect and attention.
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Another view of the person also involves the body, namely, that the former consists of the mind, the soul and the body, that is, the »tripod« of this world.
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Arising and nature of diseases
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Amaladass: Is it possible to sum up the basic philosophy of āyurveda which devotes so much of its attention to the perishable body?
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Preisendanz: The two philosophies of classical āyurveda have already been generally characterized in my response to the first question. Time allows me only to briefly sketch the first one. The basic categories of the special āyurvedic philosophy of nature are six. They are, first of all, sameness/similarity and difference which cause increase and decrease respectively of substances, specifically of the essential components of the body. These two categories also apply to other substances and to qualities which are in interaction with the body and its qualities, or may be used in the treatment of diseases resulting from an imbalance of the bodily humours. The category of substance comprises the five elements, the soul, mind, time, and space while the qualities of animate and inanimate substances, which form a further category, are manifold and of relevance to dietary behaviour and medical treatment. The category of motion is similarly tailored to fit the body as the focus of āyurveda: it refers foremost to bodily movement, further to the movements of other material substances. Finally, inherence is conceived as the fact that substances and their qualities do not occur separately. This sixfold ontological scheme underlies the theory of the arising and nature of diseases as well as their practical treatment.
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The »philosophy« of āyurveda, in the sense of its self-understanding and purpose, is formulated at various places in the Carakasaṃhitā. In a very pregnant formulation the connection with the six categories is made clear: they are considered to be causes for an effect, namely, the evenness or harmony of the essential bodily components. Any action to effect this state is the purpose of this scientific work. Another formulation implies that a modification of the natural composition of the body, as would occur through genetic manipulation, would not be an aim of medical practice because modification of the body is considered as a state of disease to be healed.
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»And the purpose of (āyurveda) is to protect the healthiness of the healthy person and to appease the (bodily and mental) modifications of the diseased person.« (Carakasaṃhitā, Sūtrasthāna 30, section 26)
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The word translated as »healthiness« literally means »the state of resting in or remaining oneself,« that is, being in one's natural state, as opposed to the state of disease defined as a modification or distortion of this natural state. To change and manipulate the very basis of the human body would thus amount to making it sick according to this basic »philosophy« of āyurveda.
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The ancient Indian physicians were also considering the possibility that nature itself could be responsible for the distortion of the natural state of the body, as we perceive it to occur in the form of genetic defects. If the »seed« of a specific component of the human body about to be formed is afflicted, this results in an abnormal modification of this new body, such as blindness or other deficiencies of the senses. However, the possibility of medical interference in such cases is not discussed, probably because »fate« was considered to be the cause here.
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Effects of past deeds and freedom of action
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Amaladass: Are there hints in the āyurvedic tradition that human beings are capable of achieving things, extolling human ability to the level of divine creation, human freedom to decide what one needs, etc., or are there also hints pointing at a faith-oriented understanding of the body?
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In general the independent and responsible agency of human beings is stressed in the āyurvedic tradition when it comes to appropriate behaviour and action, be it in the context of keeping healthy, of proper religious and ethical conduct, or of culturally adequate behaviour in general. However, there are limits to human efforts, especially for physicians. In the Carakasaṃhitā it is stated that even though it is possible to save human lives during the occurrence of epidemics, those who are destined to die at this time owing to their misdeeds in previous lives cannot be saved. Already the abnormal environmental changes which were considered to lead to epidemics are caused by the residue of transgressions or neglect of the socio-religious norms (dharma) on the part of local rulers and the local population. Such a view, if stripped of its religious connotations, is not as outdated or archaic as may appear at first sight because man-made interference with the environment – a kind of transgression of »natural norms« – which occurs locally or globally indeed conditions many so-called »natural disasters« followed by epidemics.
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The human life-span in general is determined by both the effects of past deeds and of independent responsible action in this life. These two forces jointly function in dependence on their respective strength and thus wholesome conduct can indeed lead to health and the enjoyment of the full life-span. Among the conditions to achieve the full life-span of one hundred years, we further find perfection of the Self, which refers to intellectual, ethical and spiritual perfection. Together with the evidence of related statements this shows that the welfare of the body depends on more than its material constitution, the body's various qualities, and an adequate life-style.
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Let me return to the scope of meaningful efforts of physicians. The āyurvedic tradition does not recommend that a physician treat patients with incurable diseases or patients who show signs of impending death.
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»There is no major action (performed in a previous body) whose effect is not being experienced (later on). Diseases which have arisen from such action defy any therapeutic measures and subside only after the effect of action has been exhausted (by means of its full experience).« (Carakasaṃhitā, Śārīrasthāna 1, verse 117)
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On the manipulation of human nature
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Amaladass: What would be the message from the world of āyurveda to the Western attitude of dissecting the body, interfering with nature's course of action like cloning, etc.?
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The understanding of the body within a specific religious framework which I have just sketched at least theoretically curbs human efforts to discover new drugs or treatments for doomed patients. However, there is no clear definition of the types of diseases which have arisen from previous major actions; they are more or less those for which one could not discern a cause and which were untreatable. In practice, the natural progress of āyurveda over time was probably not impeded by such theoretical statements even though medical research did not include dissection of bodies as an acknowledged means, probably on account of orthodox and culturally conditioned ideas about (ritual) purity and impurity; as far as we know the first dissections ever conducted in South Asia by South Asians took place in the thirties of the nineteenth century at British medical institutions in Kolkata.
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Similarly, although »natural diseases« which arise from the causes of old age and death by means of the transformation of time are said to be without remedy, a special section of āyurveda is concerned with rejuvenation therapy. From this point of view it is conceivable that manipulation – as practised in human genetics – of the course of nature instantiated in the human body may have attracted the minds of some classical āyurvedic physicians if it would have been thinkable and feasible. After all, rejuvenation therapy as a separate scientific branch derived from āyurveda independently evolved to include aspects of alchemy and in this context such manipulation became topical and received much theoretical attention.
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Finally, the idea of cloning would have been inconceivable to classical āyurvedic physicians because – as already mentioned – in their world-view the body is formed by various causes, an important one among them being the residues of deeds previously performed by a soul; the purpose of the body's formation under the influence of them is the arising of a specifically designed place of experience of past deeds and of further independent action on the part of this specific soul. The creation of a new, identical body out of an existing one by humans would pose a number of metaphysical and ethical problems, one of them being the lack of a soul for which this body would be appropriate as a »home.« If, however, any soul about to reincarnate could take residence in such a cloned body, its experiences there would be undeserved in the positive as well as the negative sense and it could not act out what it is supposed to experience; universal moral and soteriological justice based on the individual responsibility of souls would break down.
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Satya Nilayam: Chennai Journal for Intercultural Philosophy 7 (2005), 105-112.
Karin.Preisendanz@univie.ac.at
